Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.
Prog Neuropsychopharmacol Biol Psychiatry. 2010 Mar 17;34(2):288-93. doi: 10.1016/j.pnpbp.2009.11.022. Epub 2009 Nov 29.
Various studies have revealed that sexual dysfunction is prevalent in schizophrenia patients treated with either first- or second-generation antipsychotics. Although sexual dysfunction may have a negative impact on adherence to treatment, no reports have studied sexual dysfunction in schizophrenia patients compared with healthy controls in Asian populations. We employed a cross-sectional, case-control survey design to collect data from 352 schizophrenic Japanese outpatients treated with antipsychotics and 367 healthy subjects. Sexual dysfunction was evaluated using the Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale. The prevalence of sexual dysfunction in schizophrenic patients was 59.3% for males and 49.1% for females, while that in healthy controls was 38.0% for males and 38.4% for females. High rates of low sexual interest (37.3%), erectile dysfunction (37.3%), and problems related to ejaculation (35.6%) were found in male patients, while amenorrhea (38.7%) and low sexual interest (25.7%) were found in female patients. Significant differences were observed between cases and controls concerning the prevalence of total sexual dysfunction in males under 30 years of age (p<0.01) and in their 40s (p<0.01), as well as in females in their 30s (p<0.05) and over 50 years of age (p<0.01). When patients were divided into four monotherapy groups (risperidone, olanzapine, aripiprazole, and haloperidol), there were still no differences in any form of sexual dysfunction. The present study demonstrated a higher prevalence of sexual dysfunction in schizophrenia patients than in healthy controls. Clinicians should keep these problems in mind and discuss potential solutions with their patients in Asian populations.
各种研究表明，接受第一代或第二代抗精神病药物治疗的精神分裂症患者中普遍存在性功能障碍。虽然性功能障碍可能会对治疗的依从性产生负面影响，但在亚洲人群中，没有研究比较精神分裂症患者和健康对照者的性功能障碍。我们采用了横断面病例对照调查设计，从 352 名接受抗精神病药物治疗的日本精神分裂症门诊患者和 367 名健康受试者中收集数据。使用 Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale 评估性功能障碍。男性精神分裂症患者性功能障碍的患病率为 59.3%，女性为 49.1%，而健康对照组中男性为 38.0%，女性为 38.4%。男性患者中发现性欲低下（37.3%）、勃起功能障碍（37.3%）和与射精有关的问题（35.6%）的发生率较高，而女性患者中发现闭经（38.7%）和性欲低下（25.7%）的发生率较高。在 30 岁以下和 40 多岁的男性患者，以及 30 多岁和 50 岁以上的女性患者中，病例组与对照组在总性功能障碍的患病率方面存在显著差异（p<0.01）。当将患者分为 4 种单药治疗组（利培酮、奥氮平、阿立哌唑和氟哌啶醇）时，任何形式的性功能障碍均无差异。本研究表明，精神分裂症患者的性功能障碍患病率高于健康对照组。亚洲人群中的临床医生应牢记这些问题，并与患者讨论潜在的解决方案。
